1. HEMODIALYSIS DIALYZER
Prepared by
Nizar Belal M. Said
Supervised by
Dr. Aidah Abu Elsoud Alkaissi
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2. Equipments of Hemodialysis
Vascular access
AV-Fistula
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3. Vascular access Central Venous Catheter
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4. Dialysis machine
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5. Dialysis solution (dialysate) Acetate NaHCO3
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6. Dialysis Machine Blood pump moves blood from It consists of:
access site through the dialyzer and back
to patient, the usual flow rate ml/min,
up to 600 ml / min for ultra high efficiency
dialysis
Dialysis solution
delivery system
Monitoring devices
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7. Dialysis Machine
Heating: Dialysis solution heated by the machine to 34-39°C prior to being pump to the dializer
Venous air trap and air detector, which automatically clamps the venous blood line and shuts off the blood pump if air is detected
Blood leak detector placed in the dialysate outflow line. When a leak develops through the dialyser membrane
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8. Dialyzer Refered to as an artificial kidney
Serves as a synthetic semipermiable membrane
Replacing the renal glomeruli and tubules as the filter for the impaired kidney
In hemodialysis, the blood, laden with toxins and nitrogenous wastes is diverted from the patient to a machine, a dializer, in which the blood is cleansed and then returned to the patient
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9. Dialyzer
It is a tube with four ports, two communicate with a dialysate compartment , and two with a blood compartment
The semipermeable membrane separate the two compartments
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10. Dialyzer
The boundary area between the tow compartment is maximized by using a membrane divided into multiple hollow fibers or parallel plates
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11. Types of Dialyzer 1. Flat-Plate Dialyzer
The blood is routed between sheets of membranes laid on top of one another
The dialyzer is configured so that blood and dialysis solution pass through alternate spaces between the membrane sheets
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12. Types of Dialyzer 2. Hollow fiber
The hollow-fiber artificial kidneys contain thousands of tiny cellophane tubules that act as semipermeable membrane
The blood flows through the tubules, thousands of capillaries tightly bound in a bundle, while the dialysate circulates around the tubules
The exchange of wastes from the blood to the dialysate occurs through the semipermeable membrane of the tubules
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13. Advantages of hollow-fiber Dialyzer
Performance (The results of activities over a given period of time)
Biocompatibility refers to the ability of the dialyzer accomplish its objectives without causing hypersensitive, allergic, or adverse reaction
The amount of blood is needed to “fill” will be ml compared with plate dializer ml
The filling volume of hollow-fiber does not increase during application of a transmembrane pressure (TMP) compared wíth flat- plate dializer
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14. Nizar Belal M Said

15. High Flux Dialysis
Refers to a form of hemodialysis that was developed in recent years to improve the efficiency of dialysis
It has succeeded in both improving the quality of dialysis and in shortening dialysis times
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16. High Flux Dialysis What is the Evidence
The essential element is the use of dialyzers that have larger pores for the removal both of uremic toxins and of fluid. Membrane are thin, have large pores and very lower resistances
With high flux dialysis, BUN clearly is removed more quickly. But there is also now evidence that larger molecules may also play an important role in causing the uremic symptoms that are both annoying and dangerous to dialysis patients
Such molecules are too big to be removed by conventional dialysis, but are removed with high flux dialyzers
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17. Advantages of High Flux Dialysis
For example, a molecule called beta 2 microglobulin, which can have a role in causing arthritis in dialysis patients, is removed only by high flux dialysis
There are already reports of patients with less joint pain when switched from conventional to high flux dialysis
Allows the accurate removal of very small volumes, as well as volumes up to four liters per hour, which can never be achieved with conventional dialysis
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18. Reusing of dializer
Because of the cost, hemodializer are commonly reused in dialysis centers
With bleaching process to reuse high flux synthetic membrane dializer, clearance of large molecules is still possible, even the hemodializer is not new (Port et al 2001)
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19. Possible disadvantage of high flux dialysis
Pyrogen reactions, characterized by high temperatures in patients during dialysis treatments
Caused by small pieces of dead bacteria that can be found in the dialysate
Because high flux dialyzers have larger pores, the bacterial particles can pass more easily into the patient’s bloodstream, and that patients have more frequent pyrogen reactions. This observation remains to be confirmed
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20. Nutritional & Fluid Therapy
Restricting dietary protein:
Decrease the accumulation of nitrogenous wastes
Reduces uremic symptoms
May even postpone the initiation of dialysis for a few months
Restriction of sodium & potassium& fluids
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21. Thank You
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